Oral Presentation

Stroke mimics: a reality in stroke units

Introduction: A broad spectrum of diseases may present acutely like strokes – stroke mimics, which can represent up to 30% of the patients admitted to stroke units. The aim of this study was to describe the stroke mimic patient group, and to perform a comparative analysis between this group and the stroke patients group.

Methods: A cross-sectional, retrospective study was performed, based on clinical data analysis of 211 patients admitted to our stroke unit, during the year of 2017.

Results: From the 211 admissions, 11.3% were classified as stroke mimics. Their mean age was 65 years old and were mainly female patients (75%). The most often described symptoms at admission were headache, sensory changes like dysesthesias or paraesthesia, and decreased muscle strength. The most frequent cause of stroke mimic was conversion disorder, followed by neurological diseases, such as seizures or headache. Thirty-three percent had prior psychiatric history. Median length of stay was 7.16 days. One of the stroke mimics cases deteriorated to a fatal outcome. The authors found a statistically significant difference between both groups in what concerns: median length of stay, prior psychiatric history, gender, decreased muscle strength, imbalance, headache, involuntary movements and non-specific symptoms (such as lethargy) on admission.

Conclusion: This study may contribute to physician awareness regarding the impact of a stroke mimic diagnosis in the evaluation and guidance of stroke unit patients. These results may act as an alarm, emphasizing the relevance of proper admission anamnesis in a patient with acute neurological deficits.

From the Porto University Center of Medicine Stroke Update Course, Porto, Portugal. 26–27 June 2018.